| NPI | 1780411629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NJ 40QA02292100) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC CP043599T) |
| Enumeration Date | 2024-09-16 |
| Last Update Date | 2025-09-22 |